When Someone Refuses Help

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It is not unusual for someone struggling with an eating disorder to resist or refuse treatment. Symptoms of the eating disorder may be active for a long time before she is willing to seek help. Usually, it is when symptoms become severe or when friends or family pressure her that she surrenders, and she does so with resistance. She may disagree that she needs help, that she is severe enough, or she may deny the eating disorder completely – even when the evidence is clearly brought before her. She may be so ashamed of being revealed that she can’t consciously admit she has a problem.

An individual’s right to refuse treatment may be legally supported by a court, but minors and adults who are mentally or physically incapable to make his or her own decisions may be ordered to treatment. This can be a very difficult process. It is always appropriate to gently discuss concern first, offer treatment options. Going to treatment voluntarily is the most positive start towards recovery but this is rare.

Here are some tips to help someone along towards willingness.

  1. Try to approach the person lovingly. Explain your concern. Try to create a trusting partnership.
  2. Be a good listener. Find out why she is resisting treatment. She may be afraid of unknown places, doctors and methods of treatment. She may fear gaining or losing weight. She may worry that people will think she’s crazy.
  3. Some eating disorder specialists can help with intervention – approaching your loved one to get them into treatment. This clinician will explain the benefits of treatment, what treatment is like and what she can expect. He will also clearly describe the risks of not getting treatment. Sometimes family and friends participate in an intervention.
  4. Legal action should be reserved for situations where the patient is in immediate medical danger and she refuses any medical help.
  5. Those who struggle with eating disorders for a long time may be more resistant to treatment than a person who has been ill a short time.
  6. Individuals resistant to treatment may later accept it. This process takes patience. Once in treatment, your loved one will begin to feel better physically. Her mood may balance and she will understand why treatment was necessary.
  7. Emergency treatment is needed when symptoms become severe and life threatening. Look for rapid weight loss, chest pain, fatigue, electrolyte imbalance, fainting, dehydration and muscle cramps. If any of these symptoms are present, seek medical attention immediately.
  8. Don’t give up. Do not play tough love and give ultimatums. This approach only reinforces her feelings of low self-esteem and value. If you feel you are not making headway, consult a professional and keep trying.

Recovery is a process that begins with the willingness to get well, to make changes, and to be honest. But willingness comes slowly to most who suffer from eating disorders.